心电图C值在左心室肥大诊断中的应用  

Diagnostic value of the criterion of C value in electrocardiogram on left ventricular hypertrophy

作　　者：陈青萍[1] 黄学成[1] 袁智萍[1] 李少春[1] 刘宇田[1] 黄宁[1] 邓梓谦[1] 张凤玲[1] 

机构地区：[1]广西医科大学第三附属医院,南宁530031

出　　处：《实用心电学杂志》2009年第2期108-110,共3页Journal of Practical Electrocardiology

基　　金：广西医疗卫生自筹经费项目(项目编号Z2008445)

摘　　要：目的探讨心电图(ECG)新标准C值在诊断左心室肥大(LVH)中的价值。方法以超声心动图(UCG)结果为诊断LVH标准,对无LVH的健康人200例(A组)、有LVH之非健康者100例(B组)及无LVH非健康者100例(C组)的各项心电指标进行分析。计算A组SaVR及C值的均数及标准差,按照统计学原理确定其正常值范围,大于正常值上限作为ECG诊断LVH的新标准,并与传统标准[1]、罗氏等标准[2]比较,检验不同标准对诊断LVH的敏感性、特异性及准确性。结果①A组SaVR的电压均值(mm)为9.25±2.65,正常值范围为4～14;C值电压均值(mm)为男性24.88±6.78、女性19.46±6.52,正常值(mm)范围男性11～38、女性7～32。以SaVR>14;C值男性>38、女性>32作为ECG诊断LVH的新标准。②SaVR、C值、传统标准及罗氏等[1]标准诊断LVH的价值比较:敏感性分别为37%、75%、52%、61%;特异性分别为99%、92%、70%、90%;准确性分别为68%、83.5%、60%、77.5%。③C值男性>38mm、女性>32mm同时有QRS波电轴左偏或ST～T改变者诊断LVH的敏感性、准确性及特异性分别为88.6%、89.7%、94.1%;C值男性>38mm、女性>32mm无QRS波电轴左偏或ST-T改变者诊断LVH的敏感性、准确性及特异性分别43.3%、78.8%、91.5%。④C值在成人各年龄组中及不同体型中诊断LVH的价值差异无统计学意义。结论SaVR标准诊断LVH具有临床实用价值,新标准C值是传统标准及罗氏等标准很好的补充,可大大提高ECG诊断LVH的准确性。Objective To explore the diagnostic value of new criterion of C value on left ventricular hypertrophy （LVH）. Methods The eleetrocardiologie SaVR, criterion of C value indices were measured in 200 healthy persons （ A Group）, 100 patiernts with LVH （B Group） and 100 patients without LVH （C Group）. The diagnosis of LVH was con- firmed by ultrasonic cardiogram. The means and standard deviations of SaVR and C value in A group were calculated respectively and the normal ranges of them were made statistically. Diagnosis of LVH was examined with the new criteria, and compared with the conventional criterion （CC） as well as the criterion proposed by Luo et 81 （LC）. The sensitivity, speci- ficity and accuracy of the these criteria for diagnosis of LVH were compared. Results （1） The mean voltage of SaVR in normal group were 9.25 ± 2.65 mV, the normal range, 4 -14mV; mean C value, 24.88 ± 6.78mV（male） , 19.46 ± 6.52 mV（female） respeetively, normal ranger, 11 - 38mV（ male）, 7 - 32mV（female） respectively. （2） The sensitivity, specificity and accuracy in diagnosis of LVH with the new criteria were compared with those with the CC and the LC. The diagnostic sensitivity of SaVR,C value,CC and LC were 37%, 75%, 52% and 61% respectively; the specificity were 99% , 92%, 70% and 90% ; and the accuracy, 68% ,83.5%, 60% and 77.5%. （3）The sensitivity, accuracy and specificity of the criterion of C value more than 38mV （male） and 32mV （female） in diagnosis of LVH, associated with left - axis deviation of QRS complexes, ST - T changes, were 88.6% ,89.7% ,94.1% respectively; the sensitivity, accuracy and specificity of the criterion of C value more than 38mV （male） and 32mV （ female）, without left - axis deviation of QRS complexes, ST - T ehanges in diagnosis of LVH were 43.3% ,78.8% ,91.5% respectively. （4） The C value had no significantly statis-tic difference in diagnosis of LVH for adults of various ages and somatotypes. Conclusion The voltage criteria of SaVR po

关 键 词：左心室肥大 C值 心电图 

分 类 号：R540.41[医药卫生—心血管疾病]